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Found 8095 cases where Vaccine is PNC13

Case Details (Reverse Sorted by Appearance Date)

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VAERS ID:490843 (history)  Vaccinated:2013-04-30
Age:1.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-01
Location:Louisiana  Entered:2013-05-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSH0142781IMRL
HPV4: HPV (GARDASIL)MERCK & CO. INC.H016238 UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG750713IMRL
Administered by: Private     Purchased by: Private
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: Administration of GARDASIL to 12 month old instead of ordered Varicella. No known adverse event.

VAERS ID:490857 (history)  Vaccinated:2013-03-11
Age:1.5  Onset:0000-00-00
Gender:Male  Submitted:2013-05-01
Location:Missouri  Entered:2013-05-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 25 mg
Current Illness: URI
Preexisting Conditions: Down''s; Hypothyroidism; Eczema
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4353AA1IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0118850SCLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF000441IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0133980SCRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site reaction, Skin lesion
SMQs:
Write-up: Rt leg upper thigh 1.5/1.5 lesion on scar tissue.

VAERS ID:490903 (history)  Vaccinated:2013-04-23
Age:0.5  Onset:2013-04-24, Days after vaccination: 1
Gender:Female  Submitted:2013-04-25, Days after onset: 1
Location:Connecticut  Entered:2013-05-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Esophageal Reflux; Port Wine Nevus; NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B377BA2IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF990442IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Cough, Decreased appetite, Irritability, Pyrexia, Restlessness, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: After receiving 6 mo shots, pt had fever $g 102, fussy, decreased appetite, restless sleep. At exam next day exam benign and non focal. Possible vaccine reaction versus virus or bacterial infection. Spoke with mother on 4/28/13 who reported fever lasted 1.5 days along with decreased appetite x 3 days, slight runny nose, cough also developed within 1 day after fever gone.

VAERS ID:490925 (history)  Vaccinated:2013-04-23
Age:1.4  Onset:2013-04-24, Days after vaccination: 1
Gender:Male  Submitted:2013-04-25, Days after onset: 1
Location:Arizona  Entered:2013-05-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B154BA3IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF264823IMRL
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt to clinic with c/o redness, warmth, swelling to site and increased irritability.

VAERS ID:490936 (history)  Vaccinated:2012-08-16
Age:0.2  Onset:2012-08-20, Days after vaccination: 4
Gender:Male  Submitted:2013-04-02, Days after onset: 225
Location:New York  Entered:2013-05-06, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Pt has seen multiple specialists (Dermatology, Allergists)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH13540SCUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH1940010IMUN
Administered by: Private     Purchased by: Private
Symptoms: Eczema
SMQs:, Hypersensitivity (narrow)
Write-up: Pt was breastfeeding and doing very well. On 7/20/12 received Hep B #2, Hib #1 and DTaP #1. Developed a small patch of eczema on face (very clear skin prior to that). On 8/16/12 received IPV #1 and PREVNAR #1. Since 3 days after has had very extensive eczema.

VAERS ID:490954 (history)  Vaccinated:2013-04-24
Age:4.0  Onset:2013-05-02, Days after vaccination: 8
Gender:Male  Submitted:2013-05-06, Days after onset: 4
Location:Michigan  Entered:2013-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B330BA2IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB536BA0IMLA
HIBV: HIB (ACTHIB)SANOFI PASTEURUH525AA3IMRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.H0156230SCLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF428992IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pyrexia, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever for 2 days then rash starting on neck & groin area and spreading; Mother describes as flat, red blotches.

VAERS ID:490992 (history)  Vaccinated:2013-04-30
Age:0.5  Onset:0000-00-00
Gender:Female  Submitted:2013-05-06
Location:California  Entered:2013-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B421AA2IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH738AB2IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG750702IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0162492PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Small dime size knot on injection site with redness.

VAERS ID:490874 (history)  Vaccinated:2013-03-08
Age:1.8  Onset:2013-04-05, Days after vaccination: 28
Gender:Female  Submitted:2013-05-02, Days after onset: 27
Location:Foreign  Entered:2013-05-06, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 2013-04-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: JUL-2012, Febrile convulsion; OCT-2012, Febrile convulsion
Diagnostic Lab Data:
CDC 'Split Type': 2013133791
Vaccination
Manufacturer
Lot
Dose
Route
Site
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA21CB486A IMUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG36572 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Death, Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This is a spontaneous report from a contactable physician. This is a report received from the foreign Regulatory Authority. Regulatory authority report number DE-PEI-PEI2013022811. A 22-month-old female patient, received at the age of 21 months, a single dose of PREVENAR 13 (lot no.: G36572) intramuscularly and a single dose of INFANRIX HEXA (lot no.: A21CB486A) intramuscularly, both on 08Mar2013. Patient''s medical history included: two episodes of febrile convulsion in Jul2012 and Oct2012. Concomitant medications were not reported. On 05Apr2013, 29 days after vaccination, the patient died. At the time of reporting it was unknown if an autopsy was performed.

VAERS ID:490877 (history)  Vaccinated:2013-04-17
Age:0.4  Onset:2013-04-28, Days after vaccination: 11
Gender:Male  Submitted:2013-05-03, Days after onset: 5
Location:Foreign  Entered:2013-05-06, Days after submission: 3
Life Threatening? No
Died? Yes
   Date died: 2013-04-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': 2013135829
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME)SANOFI PASTEUR  IMUN
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Death, Sudden infant death syndrome
SMQs:, Neonatal disorders (narrow)
Write-up: This is a report from a Non-Pfizer sponsored interventional study source. A 5 month-old male patient received, at the age of 4 months, PREVENAR 13, MENJUGATE and PEDIACEL, all received intramuscularly at 0.5ml single doses on 17Apr2013. The subject had no medical history and was receiving no concomitant medications. There were no relevant tests/laboratory data. On 28Apr2013, the baby died at home due to suspected sudden infant death syndrome. The death was not expected as the baby appeared to be well at the last study visit and outreach midwives were planning to stop visiting the baby. It was not reported if an autopsy was performed. The neonatal outreach midwives who visited the baby had no details of causality at this time. The investigator considered the relationship between PREVENAR 13, MENJUGATE and PEDIACEL and the event to be not assessable. The case is managed as if the investigator''s assessment was that a reasonable possibility exists that the event was related to the study product, as a cautionary measure and for reporting purposes. This is a preliminary report for notification of a fatal event.

VAERS ID:490902 (history)  Vaccinated:0000-00-00
Age:71.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-02
Location:Foreign  Entered:2013-05-06, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': 2013135786
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site cellulitis
SMQs:
Write-up: This is a spontaneous report from a contactable physician through a sales Representative. This 71-year old male patient of unknown ethnicity was administered with PREVENAR 13 on unknown date, single dose for immunization. Relevant medical history, drug history and concomitant medication of the patient were not reported. On unknown date the patient experienced cellulitis as the injection site. The patient was given co-amoxiclav (UNSPECIFIED) for a week as a treatment to the event. At the time of report, the patient had recovered from the event.

VAERS ID:490906 (history)  Vaccinated:2013-04-02
Age:55.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-03
Location:Foreign  Entered:2013-05-06, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD; Angina pectoris; Recently, Cardiac operation
Diagnostic Lab Data:
CDC 'Split Type': 2013135023
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH20130419 UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site discolouration, Injection site erythema, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: This is a spontaneous report from a contactable physician based on information received by Pfizer [manufacturer control number 2013-0419], license party for PREVENAR 13. This is a spontaneous report from a contactable physician based on information received by Pfizer [manufacturer control number 2013-0419], license party for PREVENAR 13. A physician reported an adverse event rash occurred in a male patient who was administered with PREVENAR 13 on 02Apr2013. The rash occurred in Apr2013. The detailed description of the adverse event stated as follows: after the vaccination on 02Apr2013, the whole area of the vaccinated arm became blackish red in color. Until 12Apr2013, it was treated with monitoring. At the time of this reporting, the progress could not be known due to traffic accident. The concurrent medical history of the patient included COPD and angina pectoris, and recently the patient received a cardiac operation. The reporting physician refused to provide additional information. No follow-up attempts possible. No further information expected.

VAERS ID:490728 (history)  Vaccinated:2013-04-29
Age:4.0  Onset:2013-04-29, Days after vaccination: 0
Gender:Male  Submitted:2013-05-03, Days after onset: 4
Location:Unknown  Entered:2013-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1305USA000648
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B213BA4IMRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.H0157811SCLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF803810IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0160561SCRA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a nurse manager refers to a patient of unknown age. On 29-APR-2013 the patient was vaccinated with VARIVAX (Merck). Other suspect therapies included PROQUAD (Merck). Dosing information was not provided. The patient received a dose of VARIVAX (Merck) and a dose of PROQUAD (Merck) administered during the same visit (Overdose). No symptoms reported. Additional information has been requested.

VAERS ID:490747 (history)  Vaccinated:2013-04-29
Age:0.4  Onset:2013-04-29, Days after vaccination: 0
Gender:Female  Submitted:2013-05-03, Days after onset: 4
Location:North Carolina  Entered:2013-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ranitidine
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG750711UNLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0148981PO 
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea since 4-29-13 date of admin. Vomited

VAERS ID:490774 (history)  Vaccinated:2013-04-08
Age:0.4  Onset:2013-04-09, Days after vaccination: 1
Gender:Male  Submitted:2013-04-11, Days after onset: 2
Location:Ohio  Entered:2013-05-03, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': METROHEALTHESP201258385
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B408CA   
HIBV: HIB (OMNIHIB)SANOFI PASTEURUH772AB   
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF45132   
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CB340A   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Serum sickness, Vaccination complication
SMQs:, Hypersensitivity (narrow)
Write-up: Ot serum react d/t vacc on 2013-04-09.

VAERS ID:490735 (history)  Vaccinated:2013-03-05
Age:2.0  Onset:2013-03-05, Days after vaccination: 0
Gender:Male  Submitted:2013-05-01, Days after onset: 56
Location:Foreign  Entered:2013-05-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: 16-SEP-2010, 1st dose, PREVNAR 13, No adverse event; 16-SEP-2010, 1st dose INFANRIX HEXA, No adverse event; 27-JUN-2012, 2nd dose, INFANRIX HEXA, No adverse event
Diagnostic Lab Data:
CDC 'Split Type': 2013079994
Vaccination
Manufacturer
Lot
Dose
Route
Site
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA21C3665A2SCRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG498481SCLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Injection site erythema, Injection site haematoma, Injection site pain, Injection site warmth
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This is a spontaneous report from a contactable physician. A 33-month-old male patient received the second dose of PREVENAR 13 (lot G49848) at 0.5ml single dose, on 05Mar2013 at 10:30 am by deep subcutaneous route of administration in the left quadriceps; and INFANRIX HEXA (lot A21C3665A), single dose, on 05Mar2013 at 10:40 am by deep subcutaneous route of administration in the right quadriceps. Medical history included testicular cancer in his father. The patient had no associated disease at the time of vaccination, he had no relevant personal medical history and was not born prematurely. The patient was receiving no concomitant medication. Past product history included PREVENAR 13 (lot E48783) on 16Sep2010, he experienced no adverse event after the dose; and two previous doses of INFANRIX HEXA on 16Sep2010 and 27Jun2012, he had not experienced any event after the first two doses. The physician reported upon follow-up received on 24Apr2013, that on 05Mar2013, a few hours after vaccination, the patient experienced huge pain in the left lower limb on palpation and while leaning on the floor and painful vaccinated left lower limb, despite cold and paracetamol. On 06Mar2013, the pain was persisting and the patient was seen at an emergency room visit. The patient was apyretic, he presented with hematoma post vaccination on the quadriceps but he did not present any clinical sign of inflammation or allergy. The events were assessed as non-serious by the physician. The physician considered the events as related to vaccination but also noted that the patient was "much contracted when he awoke". Therapeutic measures taken in response to the events included treatment with DOLIPRANE and CODENFAN. The patient recovered on 09Mar2013. Follow-up (24Apr2013): New information received from the same contactable physician includes: dosing information for PREVENAR 13 (date and time, route of administration, lot number, dose number (previously reported as third dose (booster)); additional vaccination INFANRIX HEXA (given on same date); medical history, past drug history; additional event details updates events to (huge pain in the lower left limb on palpation and while leaning on the floor, painful vaccinated left lower limb, hematoma post vaccination on the quadriceps, "patient was much contracted when he awoke") (previously reported as the patient experienced an allergic reaction described as red, warm and painful vaccinated lower limb); seriousness assessment (non-serious) and causality (related to vaccination); treatment measures (DOLIPRANE and CODENFAN); outcome of patient (recovered on 09Mar2013).

VAERS ID:490579 (history)  Vaccinated:2013-04-08
Age:0.3  Onset:2013-04-15, Days after vaccination: 7
Gender:Male  Submitted:2013-04-27, Days after onset: 12
Location:New Jersey  Entered:2013-05-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Abdominal ultrasounds.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B408AA1IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH773AA1IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG689111IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0114561PO 
Administered by: Private     Purchased by: Private
Symptoms: Enema administration, Feeding disorder of infancy or early childhood, Haematochezia, Intussusception, Irritability, Pharyngitis, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Neonatal disorders (narrow)
Write-up: Pt. received rotavirus vaccine (and PEDIARIX, PREVNAR 13, HIB) on 4/8/13. On 4/15 he developed vomiting and fussiness diagnosed in office as prob. vomiting and pharyngitis. Following day he continued to feed poorly and had bloody stool. Presented to ED where he was dx''d with RUQ intussusception reduced with air enema. Required enema 2 more times.

VAERS ID:490587 (history)  Vaccinated:0000-00-00
Age:4.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-26
Location:North Carolina  Entered:2013-05-02, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF264820IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Rash on lt thigh.

VAERS ID:490624 (history)  Vaccinated:2013-04-17
Age:1.0  Onset:2013-04-23, Days after vaccination: 6
Gender:Female  Submitted:2013-05-02, Days after onset: 9
Location:Idaho  Entered:2013-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lactulose
Current Illness:
Preexisting Conditions: Allergy to PCN; Prematurity at 30.6 wks; Hearing loss
Diagnostic Lab Data: 4/25 Blood Cultures neg; CBC; CXR neg; Leg x-ray
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B157BA3IMLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB677BA0IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.H0138392IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0097810SCRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF709963IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0180150SCLL
Administered by: Unknown     Purchased by: Public
Symptoms: Blood culture negative, Chest X-ray normal, Full blood count, Pyrexia, Rash generalised, X-ray limb
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 4/25/13 fever $g 101 could not bend (R) knee started on Azithromycin took 1 dose. Developed a full body rash 4/28 started clindamycin after rash.

VAERS ID:490627 (history)  Vaccinated:2013-04-16
Age:54.0  Onset:2013-04-17, Days after vaccination: 1
Gender:Male  Submitted:2013-05-02, Days after onset: 15
Location:Tennessee  Entered:2013-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Decreased vision (L) eye
Preexisting Conditions: Allergic to Ibuprofen; HIV/AIDS; Hypertriglyceridemia; Anemia; Hypertension; Schizophrenia; Diabetes Mellitus
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG571970IMRA
Administered by: Public     Purchased by: Public
Symptoms: Laryngitis, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient received PREVNAR 13 on 4-16-13. TC from patient this pm (5-2-13) reporting he has had vomiting since 4-17-13. He is able to keep water down. Also now reports laryngitis.

VAERS ID:490636 (history)  Vaccinated:2013-04-30
Age:0.2  Onset:2013-04-30, Days after vaccination: 0
Gender:Male  Submitted:2013-04-30, Days after onset: 0
Location:Washington  Entered:2013-05-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol
Current Illness: None
Preexisting Conditions: WPW (Wolff-Parkinson-White syndrome)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B399BA0UNRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH777AA0UNRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF451440UNLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0148990PO 
Administered by: Private     Purchased by: Public
Symptoms: Gaze palsy, Pallor, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Mother states pt turned pale and eyes rolled back in his head and fell asleep. This reaction was not observed by Dr or nurse.

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